Chapter list for your book:
UNIT 1 Principles of Nursing Practice
Chapter 1
Professional Nursing Practice
Chapter 2
Medical-Surgical Nursing
Chapter 3
Health Education and Health Promotion
Chapter 4
Adult Health and Physical, Nutritional, and Cultural Assessment
Chapter 5
Stress and Inflammatory Responses
Chapter 6
Genetics and Genomics in Nursing
Chapter 7
Disability and Chronic Illness
Chapter 8
Management of the Older Adult Patient
UNIT 2 Concepts and Principles of Patient Management
Chapter 9
Pain Management
Chapter 10
Fluid and Electrolytes
Chapter 11
Shock, Sepsis, and Multiple Organ Dysfunction Syndrome
Chapter 12
Oncologic Management
Chapter 13
Palliative and End-of-Life Care
UNIT 3 Perioperative Concepts and Nursing Management
Chapter 14
Preoperative Nursing Management
Chapter 15
Intraoperative Nursing Management
Chapter 16
Postoperative Nursing Management
UNIT 4 Gas Exchange and Respiratory Function
Chapter 17
Assessment of Respiratory Function
Chapter 18
Management of Patients With Upper Respiratory Tract Disorders
Chapter 19
Management of Patients With Chest and Lower Respiratory Tract Disorders
Chapter 20
Management of Patients With Chronic Pulmonary Disease
UNIT 5 Cardiovascular and Circulatory Function
Chapter 21
Assessment of Cardiovascular Function
Chapter 22
Management of Patients With Arrhythmias and Conduction Problems
Chapter 23
Management of Patients With Coronary Vascular Disorders
Chapter 24
Management of Patients With Structural, Infectious, and Inflammatory Cardiac Disorders
Chapter 25
Management of Patients With Complications From Heart Disease
Chapter 26
Assessment and Management of Patients With Vascular Disorders and Problems of Peripheral Circulation
Chapter 27
Assessment and Management of Patients With Hypertension
UNIT 6 Hematologic Function
Chapter 28
Assessment of Hematologic Function and Treatment Modalities
Chapter 29
Management of Patients With Nonmalignant Hematologic Disorders
Chapter 30
Management of Patients With Hematologic Neoplasms
UNIT 7 Immunologic Function
Chapter 31
Assessment of Immune Function
Chapter 32
Management of Patients With Immune Deficiency Disorders
Chapter 33
Assessment and Management of Patients With Allergic Disorders
Chapter 34
Assessment and Management of Patients With Inflammatory Rheumatic Disorders
UNIT 8 Musculoskeletal Function
Chapter 35
Assessment of Musculoskeletal Function
Chapter 36
Management of Patients With Musculoskeletal Disorders
Chapter 37
Management of Patients With Musculoskeletal Trauma
UNIT 9 Digestive and Gastrointestinal Function
Chapter 38
Assessment of Digestive and
Chapter 39
Management of Patients With Oral and Esophageal Disorders
Chapter 40
Management of Patients With Gastric and Duodenal Disorders
Chapter 41
Management of Patients With Intestinal and Rectal Disorders
UNIT 10 Metabolic and Endocrine Function
Chapter 42
Assessment and Management of Patients With Obesity
Chapter 43
Assessment and Management of Patients With Hepatic Disorders
Chapter 44
Management of Patients With Biliary Disorders
Chapter 45
Assessment and Management of Patients With Endocrine Disorders
Chapter 46
Management of Patients With Diabetes
UNIT 11 Kidney and Urinary Tract Function
Chapter 47
Assessment of Kidney and Urinary Function
Chapter 48
Management of Patients With Kidney Disorders
Chapter 49
Management of Patients With Urinary Disorders
UNIT 12 Reproductive Function
Chapter 50
Assessment and Management of Patients With Female Physiologic Processes
Chapter 51
Management of Patients With Female Reproductive Disorders
Chapter 52
Assessment and Management of Patients With Breast Disorders
Chapter 53
Assessment and Management of Patients With Male Reproductive Disorders
Chapter 54
Assessment and Management of Patients Who Are LGBTQ
UNIT 13 Integumentary Function
Chapter 55
Assessment of Integumentary Function
Chapter 56
Management of Patients With Dermatologic Disorders
Chapter 57
Management of Patients With Burn Injury
Assessment and Management of Patients With Eye and Vision Disorders
Chapter 59
Assessment and Management of Patients With Hearing and Balance
Disorders
UNIT 15 Neurologic Function
Chapter 60
Assessment of Neurologic Function
Chapter 61
Management of Patients With Neurologic Dysfunction
Chapter 62
Management of Patients With Cerebrovascular Disorders
Chapter 63
Management of Patients With Neurologic Trauma
Chapter 64
Management of Patients With Neurologic Infections, Autoimmune
Disorders, and Neuropathies
Chapter 65
Management of Patients With Oncologic or Degenerative Neurologic
Disorders
UNIT 16 Acute Community Based Challenges
Chapter 66
Management of Patients With Infectious Diseases
Chapter 67
Emergency Nursing
Chapter 68
Disaster Nursing
UNIT 1 PRINCIPLES OF NURSING PRACTICE
Brunner & Suddarthts Textbook of Medical Surgical Nursing 15th Edition
Chapter 1: Professional Nursing Practice
When the nurse encourages a patient with heart failure to alternate rest and activity periods to reduce cardiac
workload, which phase of the nursing process is being used?
Planning
Diagnosis
Evaluation
Implementation
D. Implementation
Carrying out a specific, individualized plan constitutes the implementation phase of the nursing process. The nurse's
action of encouragement and instruction to the patient is part of carrying out a plan of action.
When planning care for a patient, the nurse may use a visual diagram of patient problems and interventions to
illustrate the relationships among pertinent clinical data. This format is called a
concept map.
critical pathway.
clinical pathway.
nursing care plan.
A. concept map
A concept map is another method of recording a nursing care plan. In a concept map, the nursing process is recorded in
a visual diagram of patient problems and interventions. A clinical (critical) pathway is a prewritten plan that directs the
entire interprofessional care team in the daily care goals for select health care problems.
A nurse is providing care for a patient who had a transurethral resection of his prostate this morning. The patient is
receiving continuous bladder irrigation, and the urinary catheter is now occluded. The nurse is planning to contact
the patientts health care provider and communicate using the SBAR (Situation-Background-AssessmentRecommendation) format. Which statement is a component of communication using SBAR?
"What do you think could be causing this occlusion?"
"I think that we should manually irrigate his catheter."
"What do you know about this patient and his history?"
"Could you please provide some direction for his care?"
B."I think that we should manually irrigate his catheter."
Proposing a recommendation is a component of the "R" component of SBAR communication. Asking the health care
provider for possible contributing factors to the problem or for general direction may be appropriate in some
circumstances, but these are not explicit components of SBAR. The nurse should briefly identify the patient and his
circumstances, not ask an open-ended question regarding the health care provider's familiarity.
What factor has been most clearly identified as an influence on the future of nursing practice?
Aging of the American population and increases in chronic illnesses Correct
Increasing birth rates coupled with decreased average life expectancy
Increased awareness of determinants of health and improved self-care
Apathy around health behaviors and the relationship of lifestyle to health
A. Aging of the American population and increases in chronic illnesses
The American population is aging at the same time that the incidence of chronic health conditions is increasing. There is
no noted increase in the overall awareness of the determinants of health, but at the same time, observers have not
identified apathy as a predominant attitude. Life expectancy is increasing, not decreasing.
A registered nurse (RN) has delegated the administration of IV medications to a licensed practical/vocational nurse
(LPN/LVN). Which statement accurately describes delegation?
The RN must teach the LPN how to administer the IV medications.
Ultimate responsibility for administering the medication lies with the LPN..
The RN is responsible for observing the LPN administer the IV medication
The RN is the one accountable for the quality of care that the patient receives.
D. The RN is the one accountable for the quality of care that the patient receives.
Delegation entails a redistribution of nursing work, but the RN remains ultimately responsible and accountable for the
execution of the task. It would be inappropriate to delegate if the LPN was unfamiliar with the task. The RN is not obliged
to observe the LPN's execution of the task.
In which patient care delivery model does the nurse plan and coordinate the aspects of patient care with other
disciplines focusing on continuity of care and interprofessional collaboration even if the nurse is absent?
Team nursing model
Primary nursing model
Total patient care model
Case management nursing model
B. Primary nursing model
The primary nursing model includes planning the patient's care and coordinating and communicating all aspects of care
with other disciplines and those providing care in the nurse's absence. The focus is on continuity of care and
interprofessional collaboration. Team nursing uses the RN as the team leader to organize and manage the care for a
group of patients with other ancillary workers. The RN has authority and accountability for the quality of care delivered by
the team only during the work period. In a total patient care model, the nurse is accountable for the complete care of the
patient during the assigned shift. Case management is not a model of care delivery but a collaborative process that
involves assessing, planning, facilitating, and advocating for health services with a variety of resources to promote costeffective outcomes.
A nurse with an associate or baccalaureate degree who meets licensing requirements is qualified to practice as
a nurse practitioner.
a certified specialist.
an entry-level generalist.
an advanced practice nurse.
C. an entry-level generalist
Entry-level nurses with an associate or baccalaureate degree are prepared to function as generalists. With experience and
continued study, nurses may specialize in an area of practice and may obtain certification in nursing specialties.
Certification usually requires clinical experience and successful completion of an examination. A nurse practitioner is an
example of an advanced practice nurse. An advanced practice nurse has a minimum of a master's degree with advanced
education in pharmacology and physical assessment as well as expertise in a specialized area of practice.
When nurses disagree about the effectiveness of a commonly practiced nursing intervention, the best evidence for
determining which intervention to use is
A. a systematic review of randomized controlled trials. B. a qualitative research study with a large sample size
C. a methodological Internet search using key medical terms.
D. anecdotal evidence retrieved from two or more case studies.
A. a systematic review of randomized controlled trials.
Systematic reviews of randomized controlled trials (RCTs) are considered the strongest level of evidence to answer
questions about interventions (i.e., cause and effect).
The nurse establishes priorities and determines outcomes for an individual patient during which phase of the
nursing process?
Analysis
Planning
Evaluation
Assessment
B. Planning
During the planning phase of the nursing process, patient outcomes or goals are developed and nursing interventions are
identified to accomplish the outcomes. The assessment phase of the nursing process includes the collection of subjective
and objective patient information on which to base the plan of care. The evaluation phase of the nursing process
determines if the patient outcomes have been met as a result of nursing interventions. Nursing diagnosis is the act of
analyzing the assessment data and making a judgment about the nature of the data.
A nurse is monitoring all of the patients in an outpatient procedure area for complications of administering IV
fluids. What type of nursing function is being demonstrated by the nurse?
Dependent
Independent
Autonomous
Collaborative
D. Collaborative
A collaborative nursing function is demonstrated when the nurse monitors patients for complications of acute illness,
administers IV fluids and medications per health care provider's orders, and implements nursing interventions such as
providing emotional support or teaching about specific procedures. Nursing functions may be dependent, collaborative, or
independent. The nurse functions dependently when carrying out medical orders. Physician-initiated nursing functions may
include administering medications, performing or assisting with certain medical treatments, and assisting with diagnostic
tests and procedures. Independent nursing functions include interventions such as promotion and optimization of health,
prevention of illness, and patient advocacy.
A patient is being prepared for discharge home after a laparoscopic cholecystectomy. Which team member can be
assigned to complete a discharge assessment and provide patient teaching for post-discharge care?
Registered nurse (RN)
Nursing technician (NT)
Unlicensed assistive personnel (UAP)
Licensed practical/vocational nurse (LPN/LVN)
A. Registered nurse (RN)
Nursing interventions that require independent nursing knowledge, skill, or judgment such as assessment, patient
teaching, and evaluation of care cannot be delegated. These interventions are the responsibility of the RN. The scope of
practice for LPN/LVNs is determined by each state board of nursing. The RN must know the legal scope of
practical/vocational nursing practice and delegates and assigns nursing functions appropriately. In most states LPN/LVNs
may administer medications, perform sterile procedures, and provide a wide variety of interventions planned by the RN.
UAP are unlicensed individuals who serve in an assistive role to the RN and may include nursing assistants or
technicians. The RN may delegate specific activities such as obtaining routine vital signs on stable patients,
feeding/assisting patients at mealtimes, ambulating stable patients, and helping patients with bathing and hygiene.
A group of nurses has a plan to implement evidence-based practice (EBP) for care of patients with pressure ulcers.
What will this change in practice encompass (select all that apply.)?
Consulting with the wound care and ostomy nurse
Nursest expertise and bodies of experience and knowledge C. The preferences of patients and their particular
circumstances
D. The traditions that surround pressure ulcer practices on the unit.
E. Journal articles that address the care of patients with pressure ulcers
Consulting with the wound care and ostomy nurse
Nurses' expertise and bodies of experience and knowledge
The preferences of patients and their particular circumstances
E. Journal articles that address the care of patients with pressure ulcers
EBP draws on research, data from local quality improvement, professional organization standards, patient preferences,
and clinical expertise. The particular traditions on the nursing unit are not part of EBP.
Telehealth devices are commonly used to provide which types of patient care (select all that apply.)?
Evaluation of weight loss
Medication administration
Video assessment of wounds
Monitoring peak flow meter results
Real-time blood pressure assessment
A. Evaluation of weight loss
Video assessment of wounds
Monitoring peak flow meter results
Real-time blood pressure assessment
Telehealth enables the nurse to provide distance assessment, planning, intervention, and evaluation of outcomes of
nursing care using technologies such as the Internet, digital assessment tools, and telemonitoring equipment. Among the
many uses of telehealth are monitoring patients with chronic or critical conditions and helping patients manage symptoms.
Which interventions are independent nursing actions (select all that apply.)?
Reinserting an IV
Assessing lung sounds
Obtaining informed consent
Administering IV medication
Turning a patient every two hours
Reinserting an IV
Assessing lung sounds
E. Turning a patient every two hours
Independent nursing actions are those that a nurse is legally able to order or begin independently (e.g., turn every two
hours, monitor for complications). Dependent interventions are physician-initiated. Medication administration is
collaborative care as the health care provider must order the medication. The health care provider legally must obtain
informed consent from the patient, although the nurse may witness the consent.
A patient with coronary artery disease is admitted to the hospital. An electronic health record (EHR) is generated for
the patient. Which information will be present in the EHR? Select all that apply.
Medications
Laboratory data
Financial background
Educational qualifications
Medical and surgical history
Medications
Laboratory data
Medical and surgical history
The electronic health record (EHR) is a computerized record of protected health information (PHI). It includes information
such as patient demographics, progress notes, problems and medications, vital signs, medical history, immunizations, and
laboratory and radiology reports. The educational qualifications of the patient are not included in EHR. Similarly, the
financial background of the patient is not mentioned in the EHR.
When planning care for a patient, the nurse may use a visual diagram of patient problems and interventions to
illustrate the relationships among pertinent clinical data. What is this format called?
Concept map
Critical pathway
Clinical pathway
Nursing care plan
Concept map
A concept map is another method of recording a nursing care plan. In a concept map, the nursing process is recorded in
a visual diagram of client problems and interventions. A clinical (critical) pathway is a prewritten plan that directs the entire
health care team in the daily care goals for select health care problems. A nursing care plan is a documented plan of care
for a patient.
A nurse is dispensing medications to patients. What precaution should the nurse take to ensure the safe use of
medications?
Discard all unlabeled medicines.
Use hand sanitizer only after contact with the patient.
To increase efficiency, place the medicines for the next dose at the bedside.
To verify that medicines have been checked, relabel medicines which already have a label provided by Pharmacy.
Discard all unlabeled medicines.
The nurse should discard all unlabeled medicines to ensure the safety of medications. Unlabeled medicines are difficult to
identify. The nurse should avoid placing medicines that are scheduled for a later time at the bedside; the patient may
accidentally consume them and this may result in an overdose. Relabeling medicines that are already labeled should be
avoided because it can lead to inaccurate administration. Soap, water, and hand sanitizer should be used before and after
contact with the patient to reduce the risk of infections.
The nurse is reviewing the use of linkages among NANDA-I nursing diagnoses, Nursing Outcomes Classification
(NOC) patient outcomes, and Nursing Interventions Classification (NIC) nursing interventions. Which statement
best describes the use of these linkages?
They are used to evaluate data.
They help the nurse to predict the results of nursing care.
They provide guidance and are the basis for planning care.
in sepsis is a secondary problem associated with the acidosis/anaerobic metabolism of septic shock. Pulmonary embolism
is a cause of obstructive shock. Fluid loss is the major cause of hypovolemic shock.
When neurogenic shock occurs, interruption in sympathetic nerve impulses causes:
A.tachycardia.
hypertension.
C.hypoventilation.
D.vasodilation.
D.vasodilation.
In neurogenic shock, there is an interruption of impulse transmission or blockage of sympathetic outflow, resulting in
vasodilation, inhibition of baroreceptor response, and impaired thermoregulation. Interruption of sympathetic nerve
innervation would result in bradycardia. Interruption of sympathetic nerve innervation would result in hypotension.
Hypoventilation is not a physiological mechanism.
Blood pooling in the capillary bed and arterial blood pressure too low to support perfusion of vital organs cause:
A.acute respiratory distress syndrome (ARDS).
B.disseminated intravascular coagulation (DIC).
C.increased cerebral perfusion pressure.
D.multisystem organ failure and/or dysfunction.
D.multisystem organ failure and/or dysfunction.
Maldistribution of blood flow refers to the uneven distribution of flow to various organs and pooling of blood in the capillary
beds. This impaired blood flow leads to impaired tissue perfusion and a decreased oxygen supply to the cells, all of which
contribute to multiple organ failure. Damage to the type II pneumocytes leads to ARDS. Consumption of clotting factors
may cause DIC. Low arterial blood pressure leads to decreased cerebral perfusion pressure.
The nurse is caring for a patient admitted with severe sepsis. The physician orders include the administration of
large volumes of isotonic saline solution as part of early goal-directed therapy. Which of the following best
represents a therapeutic endpoint for goal-directed fluid therapy?
Central venous pressure > 8 mm Hg
Heart rate > 60 beats/min
Mean arterial pressure > 50 mm Hg
Serum lactate level > 6 mEq/L
A.Central venous pressure > 8 mm Hg
Early goal-directed therapy includes administration of IV fluids to keep the central venous pressure at 8 mm Hg or greater.
Additional therapeutic endpoints include a heart rate at less than 110 beats per minute and a mean arterial blood pressure
at 65 mm Hg or greater. Serum lactate levels are elevated in sepsis; target levels should be < 2.2 mEq/L.
The nurse is admitting to the ICU a patient in early sepsis. What is the nursets best understanding of the patientts
nutritional requirements?
Total parenteral nutrition is preferred.
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